Advice Of Health Professionals Research Articles

Kidney Smartphone Diagnostics.

Here we present a method for a mobile point-of-care (POC) testing of urinary albumin concentration, a biomarker of kidney damage and cardiovascular disease. The self-testing strips are meant to be interpreted by means of a smartphone application. The limits of detection range from 0.15 to 0.30g/L urinary albumin, though results below 0.10g/L are presented in a quantitative manner and estimates larger than this threshold are shown as categorical variables in a qualitative manner for increasing urinary albumin concentrations. Calibrated once under standard conditions, the app enables the user to capture problem samples and calculate the corresponding concentration. Negative and positive findings must be interpreted, taking into account the inherent limitations of the method, and professional health advice must be requested for diagnostic considerations. Acknowledgment of the association between early life nutrition and long-term renal health and the adoption of preventive strategies targeting high-risk groups is key for the reduction of the burden of chronic kidney disease on a global scale.

Breastfeeding questions to medicines call centres from the Australian public and health professionals.

There is considerable uncertainty regarding medication use during breastfeeding. This study compared lactation-related questions about medicines from consumers and health professionals to identify knowledge gaps. A retrospective, mixed-methods study of lactation-related call data extracted from two Australian medicines call centre databases: National Prescribing Service (NPS) Medicines Line (ML) for the general public and Therapeutic Advice and Information Service (TAIS) for health professionals, was conducted. Of the 5662 lactation-related calls by consumers to ML, most were from women enquiring about themselves (95%). The 2219 lactation-related calls from health professionals to TAIS were largely from GPs (46%), community pharmacists (35%) and nurses (12%). Consumers commonly enquired about medicines freely accessible or over-the-counter, including non-steroidal anti-inflammatory products (9.3%), paracetamol (6.9%), ibuprofen (4.8%) and codeine (4.2%). Health professionals' questions involved prescription medicines such as antidepressants (16.9%), with queries on sertraline (3.7%), levonorgestrel (2.7%) and domperidone (2.4%) most common. Question themes were similar for both cohorts, focusing mainly around medication safety, risk minimisation and milk supply. Understanding the compelling and common themes driving medicines help-seeking related to breastfeeding is key to addressing information gaps and improving overall medication use during breastfeeding.

Determinants of participating in life after spinal cord injury – advice for health professionals arising from an examination of shared narratives

Purpose: To explore the perceived determinants of participation in life after spinal cord injury and incorporate these into a framework for the promotion of participation suitable for use by rehabilitation professionals.Method: Four people with spinal cord injury and one health service researcher engaged in a process of sharing narratives of life after spinal cord injury over a period of one year. The narratives were distilled using thematic analysis.Results: The relevant subset of data from the narratives categorized as This is what we think determines our participation in life was analyzed in depth to reveal nine themes (1) The world can be my friend or foe; (2) I am who I am; (3) It is a personal journey; (4) Some like to talk, others like to do; (5) We have the technology; (6) A support network is vital and it can be built; (7) Life involves tradeoffs; (8) Push; and (9) Be flexible. These themes were combined into a framework for the promotion of participation to be used by rehabilitation professionals. The collaboratively developed framework has three aspects – Help me, Encourage me and Accept.Conclusion: The proposed participation promotion framework is grounded in the narratives of the research group but needs to be tested before it can be endorsed for practice.Implications for RehabilitationIn order to promote participation in life after spinal cord injury rehabilitation professionals can help people with spinal cord injury to negotiate the world, build and maintain a support crew and access equipment and technology.Spinal cord injury rehabilitation professionals can encourage people with spinal cord injury to push themselves, be assertive and be flexible, as these attributes can assist participation in life after spinal cord injury.In the pursuit of participation goals, rehabilitation professionals must accept the individuality of each person with spinal cord injury, respect that they may or may not be willing to make tradeoffs to achieve participation goals and that they are on an ever changing life journey.

Drivers for human papillomavirus vaccination in Valencia (Spain)

ObjectiveTo describe the drivers associated with HPV vaccination in adolescent girls and their parent's opinion on the vaccine. MethodsWe conducted an observational and cross-sectional study on adolescent girls and their parents in Valencia (Spain), between September 2011 and June 2012. A consultation was made at a random sample of schools of the 14-year-old girls that should have received the vaccine in the free vaccination programme. We ran a personal survey on knowledge and attitudes regarding HPV infection and the vaccine. A binary logistic regression model was performed to determine which factors were most associated with vaccination. ResultsThe survey was run on a binomial of 1,278 girls/mothers in 31 schools, to which 833 girls and their mothers responded (64.0%). The factors associated with vaccination were: country of origin of the families (adjusted OR [aOR]: 0.49; 95% confidence interval [95%CI]: 0.24-0.98), civil status of the parents (aOR: 0.33; 95%CI: 0.13-0.81), knowledge/beliefs about the vaccine when the source of information was the nurse (aOR: 1.83; 95%CI: 1.01-3.35), information source about the vaccine (aOR: 2.32; 95%CI: 1.37-3.92), preventive health centre visits (aOR: 2.1; 95%CI: 1.10-4.07), and nurse advice (aOR: 6.6; 95%CI: 3.19-13.56). ConclusionsThe main factor associated with HPV vaccination was the advice of health professionals. Therefore, the most effective interventions to improve vaccination coverage should focus on health professionals.

Developing a Knowledge-Based System for Diagnosis and Treatment of Malaria

Malaria is a serious and fatal disease caused by a parasite that can infect a certain type of mosquito which feeds on human blood. It is a public health problem in Ethiopia and a major cause of illness and death. More than 75% of the total land of Ethiopia is malarious affecting more than 68% of the population, making malaria the leading public health problem in Ethiopia. In an effort to address such problems, it is important to develop knowledge-based system (KBS) that can provide advice for health professionals and patients to facilitate diagnosis and treatment of malaria patients. Experimental research design was used to developed prototype system. Purposive sampling technique was used to select domain experts for knowledge acquisition. The domain experts are selected from Jimma special hospital, Adama hospital and Agaro health centre. The knowledge was acquired using both structured and unstructured interviews from domain experts and represented by production rule, (if- then method). The user's acceptance of the prototype system by visual interaction method that by showing the prototype system to the domain experts was conducted result is 83.21%. In addition, performance of the prototype system was evaluated using case testing method and produce result of 82.3%. It is promising to save the life of people in rural area where there is scarcity of health professionals and apparatus. In addition, it is possible to reduce time and cost of diagnosis and treatment in health centre by implementing intelligent systems. Developing in local languages, good interface programming language and in other techniques are the future works of the study.

Management of Snoring and Sleep Apnea in Australian Primary Care: The BEACH Study (2000-2014).

To characterize the changes in management of snoring and obstructive sleep apnea (OSA) in general practice in Australia. The Bettering the Evaluation And Care of Health (BEACH) study is a nationally representative rolling cross-sectional survey of general practice activity in Australia. We analyzed all adult (age 18+ y) encounters for OSA or snoring, annually from 2000 to 2014 (approximately 1,000 general practitioners (GPs) per year recording approximately 100,000 patient encounters per year). The management rate of OSA rose from 94 to 296 per 100,000 encounters, whereas management rate of snoring remained steady at approximately 15 to 25 per 100,000 encounters. The majority of patients managed for OSA were: middle-aged (25-64 y; 71.3% of all patients); overweight (90%); male (62%), although there was a trend for an increase in the proportion being female over the study period (21 to 37 per 100 encounters). Referral rates were high for both OSA (59 per 100 problems managed) and snoring (69 per 100), although medical referrals (to a sleep clinic or respiratory physician) were significantly higher for patients managed for OSA than for snoring (90% vs. 60% of all referrals). Surgical referrals were higher for snoring than for OSA (37% vs. 3% of all referrals). The management rate for OSA tripled from 2000 to 2014, while the rate for snoring remained steady. GPs significantly relied on the advice of other health professionals to manage OSA; however, their referral patterns aligned with what most specialists would recommend. A commentary on this article appears in this issue on page 1081.

Cow's Milk Allergy Prescribing Is Influenced by Regional and National Guidance.

Cow's milk allergy (CMA) is the most common food allergy in children with many clinical manifestations, leading to misdiagnoses such as gastro-oesophageal reflux, infantile colic, and lactose intolerance with inappropriate prescribing. We aimed to determine the impact of infant feeding guidelines on CMA prescribing in UK primary care using a simple and inexpensive training package. Prospectively collected data of infant feeding prescriptions in Northern Ireland from June 2012 to March 2014 were analysed with the intervention period between November 2012 and March 2013. A comparison was made between hypoallergenic formulae, appropriate for CMA, versus alternative prescriptions including antiregurgitation and colic products, lactose-free and partially hydrolysed milks, or infant Gaviscon. Comparing pre- and postintervention period, the total quantity of hypoallergenic formulae increased by 63.2% and alternative prescriptions decreased by 44.6% (P < 0.001). The total amount of all prescribed products decreased by 41.0% (P < 0.001). During the study period, the proportion of recommended CMA treatment increased from 3.4% before training to 9.8% in the short- and long-term follow-up (P < 0.001). The overall increase was £33,508 per year or £95.5 per general practitioner's surgery. We present the first study evaluating the impact of infant feeding guidelines on CMA prescribing in UK primary care. Practical advice and teaching of health professionals allowed for effective implementation of regional and national guidelines, with a significant impact on prescription patterns. This study shows promising results for prospective research on a national scale, including socioeconomical impact and cost-effectiveness.

Barriers, facilitators, and strategies to support healthy eating among recent Hispanic immigrants mothers living in a food swamp: a Photovoice project

ObjectiveFollowing the social‐ecological framework, we aimed to identify barriers and facilitators that Hispanic primary caregivers living in a “food swamp” experience when providing foods for their children, and their strategies to overcome those barriers. “Food swamp” is a term referring to low‐income areas with high concentrations of food stores, including convenience stores and fast‐food outlets.MethodsUsing a purposive sampling design, we identified 15 Hispanic mothers of young children (&lt; 10 years old) living in a neighborhood characterized as a “food swamp” in the metropolitan area of Washington DC. Semi‐structured, in‐depth interview guides were used to ask mothers to describe: (a) their typical day, (b) whether they were able to feed their children the foods they would like to, and (c) what made it easier or harder for them to provide the foods they would like to provide for their children. Mothers were also asked to take pictures of those factors. A community organizer led a participatory workshop to display all the pictures, each with a descriptive title and paragraph crafted by the mothers. The workshop sought to identify common barriers and their strategies to overcome them. Interviews from all sessions were recorded, transcribed verbatim, and analyzed systematically using a codebook that followed broad categories of the social‐ecological framework (ATLAS.ti version 5).ResultsMothers were immigrants (&lt;15 years in US) mostly El Salvador and Guatemala. The divide between children's food preferences and parent's rules and preferences around eating emerged as a common barrier. For example, mothers wanted to feed their children typical foods based on soups, rice, and tortillas from their home country, while the children preferred to eat foods that mothers perceived were common to the receiving country (pizza, fries, fried chicken). Mothers perceived that foods and drinks served at school were of low nutritional value and were concerned that this exposure reinforced preferences for these foods in their children. Eating at fast‐food restaurants as a family was common only when the monthly budget allowed. The high price for some meats, fruits, and vegetables was a common barrier cited, but mothers’ reported that their ability to manage the family budget and to find less expensive alternatives to these items enabled them to feed their children how they wanted throughout the month. WIC food vouchers also allowed mothers to purchase fruits and vegetables that they otherwise would not have been able to afford. The advice of health professionals (doctors, dentists, nutritionists) emerged as a key factor in deciding what to feed their children. Strategies identified in the workshop included: education on how to incorporate local fruits and vegetables (perceived as less expensive than imported ones), parent involvement in the school lunch options.ConclusionThe mothers were strict gatekeepers of their children's diets, following health professionals’ advice and using budgeting strategies throughout the month to cope, regardless of what was available in the environment surrounding their homes. Exposure to foods perceived as unhealthy in the school was seen as a major barrier to feeding their children what they preferred.Support or Funding InformationGW Center for Civic Engagement, and Centers for Disease Control and Prevention (Racial and Ethnic Approaches to Community Health).

Caught in the middle? How women deal with conflicting pregnancy-advice from health professionals and their social networks

Objectiveto investigate how pregnant women deal with conflicting advice from their social networks and their caregivers and how this influenced their pregnancy-related behaviours. Design and methodsa qualitative study based on face-to-face interviews and focus-groups. We applied an inductive analysis technique closely following the ‘Gioia method’. Settingimpoverished neighbourhoods in Rotterdam, the Netherlands. Participants40 women who were pregnant, or had given birth within the last 12 months. 12 women were Native Dutch, 16 had a Moroccan background, and 12 had a Turkish background. Findingsall women faced a misalignment of advice by health professionals and social networks. For the native Dutch respondents, this misalignment did not seem to present a challenge. They had a strongly articulated preference for the advice of health professionals, and did not fear any social consequences for openly following their advice. For the women with a Turkish/Moroccan background, however, this discrepancy in advice presented a dilemma. Following one piece of advice seemed to exclude also following the other one, which would possibly entail social consequences. These women employed one of the three strategies to deal with this dilemma: a) avoiding the dilemma (secretly not following the advice of one side), b) embracing the dilemma (combining conflicting advice), and c) resolving the dilemma (communicating between both sides). Key conclusions and implications for practicewe argue that the currently popular interventions geared towards increasing the health literacy of non-Western ethnic minority pregnant women and improving communication between ethnic minority clients and caregivers are not sufficient, and might even exacerbate the dilemma some pregnant women face. As an alternative, we recommend involving not only caregivers but also women׳s social network in intervention efforts. Interventions could aim to increase the negotiation capacity of the target group, but also to increase the health literacy of the members of their social network to enable the circulation of ‘new’ information within a rather homogeneous, tight-knit network.

Socio-cultural Foundations of Caregiver Institutions: Lineage and Community Networks in Zimbabwe’s Health Care System

This study sought to investigate factors that affect caregiver compliance to professional health advice with reference to children. An anthropological approach was used and clients were observed from mainstream health facilities to their homes to analyze the broader social structures, in familial settings, that influence decision making and final practices of the caregiver who visits the health centres. The study revealed a more complex pattern with a sophisticated cultural structure of caregivers who control and make decisions other than the person who visits the facility. Often this structure is unknown to mainstream health professionals with consequences on efficacy. In addition to the social structures is a powerful belief system that conditions the caregiver. This significantly compromises the advice by mainstream health professionals in a dual health care delivery system as Zimbabwe's. The study recommends that to improve on caregiver compliance mainstream health professionals need to know and engage this other invisible caregiver structure.&#x0D;

Bilingualism, Language Disorders and Intercultural Families in Contemporary Italy: Family Relations, Transmission of Language and Representations of Otherness.

This study aims to show how language disorders in children affect language transmission and the mixedness experience in intercultural families. To this end, it adopts a qualitative method of study based on the administration of ad hoc interviews to intercultural couples who consulted our Child Neuropsychiatry Service because of language disorders in their children. One of the main consequences, when the child of an intercultural couple presents a language disorder and a diagnostic process has to be initiated, may be interruption of the transmission of the second language, especially if it is the mother's language. The decision to do this, which may be taken on the advice of teachers and health professionals, but also because the parents themselves often attribute their child's language disorder to his bilingual condition, affects not only the relationship between the mother and her child, but also processes in the construction of parenthood and in the structuring of the child's personality and the plurality of his affiliations. A clear understanding of how the dialectic between the categories of "alien" and "familiar" is managed in these contemporary families, which have to reckon with the condition of otherness, is crucial for psychiatrists and psychotherapists working in settings in which cultural difference is an issue to consider.

Does Individualized Health Information regarding Alcohol Consumption Affect Consumption among Risky Drinkers?

Studies testing the effect of physician advice on alcohol consumption in a noncontrolled environment have not specifically focused on risky drinkers. Therefore, it is possible that the estimated effect of professional health advice primarily reflected moderate drinkers' responses. We assessed whether professional health advice reduced alcohol consumption among risky and binge drinkers in a real-world setting. Retrospective cohort analysis. We used 2009 Behavioral Risk Factor Surveillance System Annual Survey Data. Five thousand seven hundred thirty-five adult male and nonpregnant female risky drinkers, with hypertension or borderline hypertension, who reported on whether they were advised to reduce alcohol consumption. Dependent variable: respondent was currently reducing alcohol use to control hypertension (1 = yes; 0 = no). Primary regressor: respondent claimed to have received advice from a health professional on reducing alcohol consumption to control hypertension (1 = yes; 0 = no). The model was estimated using generalized maximum entropy. Professional health advice increased the probability that both risky (marginal effect [ME] = .09), and binge drinkers (ME = .07) reduced their alcohol consumption. Our findings indicate that risky drinkers can effectively be targeted with consumption advice. This has important policy implications given that society bears the largest cost for this group, whereas moderate drinkers have been found to be relatively productive and healthy.

Socio-cultural Foundations of Caregiver Institutions: Lineage and Community Networks in Zimbabwe’s Health Care System

This study sought to investigate factors that affect caregiver compliance to professional health advice with reference to children. An anthropological approach was used and clients were observed from mainstream health facilities to their homes to analyze the broader social structures, in familial settings, that influence decision making and final practices of the caregiver who visits the health centres. The study revealed a more complex pattern with a sophisticated cultural structure of caregivers who control and make decisions other than the person who visits the facility. Often this structure is unknown to mainstream health professionals with consequences on efficacy. In addition to the social structures is a powerful belief system that conditions the caregiver. This significantly compromises the advice by mainstream health professionals in a dual health care delivery system as Zimbabwe's. The study recommends that to improve on caregiver compliance mainstream health professionals need to know and engage this other invisible caregiver structure.

J10 Musical Communication And Health Care In Advanced Stages Of Huntington's Disease - A Mixed Method Multiple Case Study Of Collaborative Individualised Music Therapy

Context Huntington’s disease (HD) is a rare neurodegenerative disease. In late stages of HD, a triad of symptoms affects communication for everyone affected by the disease, either being a patient with HD, family or health professionals. Communication disability results in the patient being affected either by apathy or frustration. This makes interactions in HD health care a challenging task. Health care in advanced stages aims to improve quality of life. There is no cure. The health care at NKS Olaviken hospital for old age psychiatry is based on a model of primary caregivers and some therapies limited in time. One therapy that helps with communication is music therapy (MT). MT differs from conventional verbal communication as MT is based on musical interactions. Music therapists working with HD report that MT can meet emotional, communication and self-expression needs. Research is limited yet promising. Research question: How does collaborative individualised music therapy affect the quality of care in a specialised nursing home for patients in advanced stages of Huntington’s disease? Objectives and aims 1) to gain more knowledge about how music therapy can facilitate communication between patient and professional caregivers; 2) to better understand how participation in music therapy can strengthen relationships in professional health care of a complex neurological condition. The suggested study aims to uncover some general advice for health professionals wishing to do collaborative work. Summary of content This suggested exploratory study will through mixed methodology include primary caregivers in collaborative individualised MT with patients with HD at NKS Olaviken, exploring musical communicativeness. Significance MT to improve quality of giving and receiving health care.

The burden of obesity: personal stories, professional insights.

The word obesity invokes multiple connotations that contain a realm of disparate descriptions ranging from disease to disdain. There are also few other human conditions that cause increased morbidity and mortality and affect millions of individuals worldwide yet is still viewed by many as a character fault or moral failure. Herein we have the opportunity to read the personal reflections of individuals with obesity who have struggled with their weight over a lifetime. Through a series of 12 narratives, the authors collectively share their shame, humiliation, dignity, inner strength and advice for health professionals who they entrust.

A qualitative study of mental health help-seeking among Catholic priests

Little is known about Catholic priests' mental health help-seeking. Using consensual qualitative research, this study examined 15 Catholic priests' narratives about help-seeking attitudes, help-seeking behaviours, and offers advice for mental health professionals regarding priest health. Analysis revealed that all 15 priests reported positive attitudes about mental health help-seeking because counselling helped to deal with and heal problems, provided a different, unbiased perspective and allowed for spiritual growth. The majority of participants (9/15; 60%) reported that they have sought help through counselling for various reasons, such as depression and stress. Barriers to help-seeking entailed perceiving no need to seek help, stigma, and concerns about counsellor competence. Participants suggested that mental health professionals understand the importance of prayer to priests, the unique stressors of the priestly role, and the impact of contextual factors (e.g., frequent transfers and sexual abuse scandal) on their health. Implications for future research and clinical practice are discussed.

How do we better translate adherence research into improvements in patient care?

Adherence to medicines in patients with chronic disease remains poor despite better recognition of the challenges of non-adherence and a concerted effort to address these challenges. Adherence research has progressed in recent years, both conceptually with the recent development of a taxonomy of adherence [1] and improved, if still flawed, evidence for the efficacy of some interventions [2]. However, a key challenge remains unmet: the translation of adherence research into clear advice for health professionals of effective strategies to better support the medication adherence of their patients. We outline some of the difficulties of improving the translation of adherence research into improvements in the care of individuals with chronic disease, and consider possible solutions. We have two suggestions for improving translation of adherence research: (1) better incorporation of what we know about adherence into interventions to improve adherence and (2) more sophisticated measurements of adherence. Implementing these suggestions has implications for research and practice.

Maternal Perception and Attitudes Regarding Healthcare Professionals’ Guidelines on Feeding Practices in the Child's First Year of Life

ObjectiveTo evaluate the maternal perceptions and attitudes related to adherence to healthcare professionals’ guidelines on breastfeeding and complementary feeding, and associated factors. MethodsA cross-sectional analysis of data from a randomized field trial was performed, in which 20 health centers (HCs) were selected in the city of Porto Alegre, state of Rio Grande do Sul, from eight Health Management Districts of the city. Pregnant women were selected from these HCs, and when the children were aged between six and nine months, data regarding the maternal perception of adherence to professional advice and consequences of feeding practices on child health were obtained during home visits. Association analyses were performed using Poisson regression. ResultsData were collected from 631 mother-child binomials. According to the mothers’ perception, 47% reported not following instructions received in the HC. Among these, 45.7% did not recognize the importance of eating habits for the child's health. The perception of adherence to professional advice was associated with higher prevalence of exclusive breastfeeding (EBF), introduction of solid food (ISF) after four months, introduction of non-recommended foods after six months, and higher family income. A higher prevalence of EBF and ISF was observed after four months (p < 0.05) among mothers who believed in the importance of feeding habits for the child's health. ConclusionThere was a high prevalence of mothers who did not follow the advice of health professionals; the perception that food does not affect the child's health can be a barrier to the improvement of eating habits in childhood.

Maternal perception and attitudes regarding healthcare professionals’ guidelines on feeding practices in the child's first year of life

ObjectiveTo evaluate the maternal perceptions and attitudes related to adherence to healthcare professionals’ guidelines on breastfeeding and complementary feeding, and associated factors. MethodsA cross-sectional analysis of data from a randomized field trial was performed, in which 20 health centers (HCs) were selected in the city of Porto Alegre, state of Rio Grande do Sul, from eight Health Management Districts of the city. Pregnant women were selected from these HCs, and when the children were aged between six and nine months, data regarding the maternal perception of adherence to professional advice and consequences of feeding practices on child health were obtained during home visits. Association analyses were performed using Poisson regression. ResultsData were collected from 631 mother-child binomials. According to the mothers’ perception, 47% reported not following instructions received in the HU. Among these, 45.7% did not recognize the importance of eating habits for the child's health. The perception of adherence to professional advice was associated with higher prevalence of exclusive breastfeeding (EBF), introduction of solid food (ISF) after four months, introduction of non-recommended foods after six months, and higher family income. A higher prevalence of EBF and ISF was observed after four months (p < 0.05) among mothers who believed in the importance of feeding habits for the child's health. ConclusionThere was a high prevalence of mothers who did not follow the advice of health professionals; the perception that food does not affect the child's health can be a barrier to the improvement of eating habits in childhood.

Gay, lesbian, bisexual, and transgender aging: challenges in research, practice, and policy

The graying of the U.S. population draws increasing focus to historically unattended segments of society, including sexual and gender minorities. In this first comprehensive volume to address the challenges of aging in the gay, lesbian, bisexual, transgender, and intersex populations, this text presents what is currently known about aging GLBT individuals and what services are needed to support them. The editors first provide an introductory overview comparing caregiving in GLBT and normative aging communities. In chapters devoted to the issues of each alternative sexuality and gender identity community, top experts in the field discuss biomedical, psychological, social/sexual, spiritual, socioeconomic, and service topics related to that community's aging needs. GLBT populations face unique challenges as they age. Despite the often severe difficulties they encounter, many live out their final years with the dignity and grace that all of us deserve. With a combination of the latest biological and social science research, moving case studies and first-person accounts, practical advice for health professionals, and research literature citations, this book represents a major step forward in addressing concerns of aging GLBT populations. Integrating research, practice, and policy, this text is for students and professionals in gerontology, medicine, social work, psychology, nursing, public health, and related fields who wish to learn more about the life experiences and concerns of sexual- and gender-minority-identified older patients.